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Dear Doctor, My Wife Is 30th Week Pregnant Now By

Posted on Tue, 23 Jul 2019

Question: Dear doctor, My wife is 30th week pregnant now by IVF. she has hypertension and was taking Labetalol 100mg thrice a day from the beginning of pregnancy. her Last menstrual period was on November 18th 2018. In dec. 2018 her bp was 130/90. then in XXXXXXX 2019 bp was 120/80. but in mid of may her bp again became 130/90. Then the gynaecologist who did ivf asked to take labetalol 200mg thrice a day. then after 10 days that is on 10th XXXXXXX her bp was 115/80. we are going to have delivery in another hospital ( Christian medical college - CMC , vellore), there the gynaecologist said 200mg thrice is not safe for baby and asked to take 100mg thrice a day. please tell me which dose she should take. Also one more thing in Nov.2018 her weight was 59.7 kgs. we took growth scan on 21st may on that day her weight was 70kgs and baby weight was 871gms. but today 21st XXXXXXX her weight is 69.7kgs she has reduced 300gms. is this normal or what should we do?. Thanks.

Answered by Dr. Dr. Rakhi Tayal (19 minutes later)

Brief Answer:
Try to control BP by reducing salt intake.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.

A dose of Labetalol of 200mg thrice a day is high. It is better to try to control her blood pressure with a lowe dose of 100mg thrice a day with salt restriction.

The decrease of weight by 300 gms is not worrisome and such a small weight loss will rather help in reducing the swelling of feet and may help in controlling her BP. She has already gained 10 kgs of weight during pregnancy.

She can try to maintain her weight by decreasing fat intake and increasing the number of proteins in her diet.

Please feel free to discuss further.
I will be glad to answer the follow-up queries that you have.

Wishing you good health.

Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Rakhi Tayal (2 days later)

Dear Doctor, I have attached growth scan report. The head circumference is only 25 weeks 2 days while the scan was taken on 26 weeks 2 days. Is this normal? Thanks.

Answered by Dr. Dr. Rakhi Tayal (33 hours later)

Brief Answer:
Report not attached.

Detailed Answer:
Hello.
There is no attached report with this query. A minor difference of 7 days in the head circumference is not worrisome in case the amount of liquor around the baby is normal.
Regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Rakhi Tayal (2 days later)

Dear doctor, my wife was given heparin Injection daily from the day of embryo transfer. And from 4th month she was asked to take heparin Injection once in three days. also she is taking ecosprin 75mg once daily in afternoon. but we are going to have delivery in another hospital (cmc, vellore), there the gynaecologist said to stop heparin Injection and ecosprin. but in ivf centre they said not to stop Because she has hypertension. we are confused now please advice us on this. also she is given to use progesterone vaginal insertion capsule in ivf centre which was also asked to stop in cmc. please advice us on this too. Thanks.

Answered by Dr. Dr. Rakhi Tayal (12 hours later)

Brief Answer:
Can be stopped after blood investigations.

Detailed Answer:
Hello.
Thanks for writing again.
Heparin and ecosprin help in avoiding any coagulation and increase the placental blood flow that helps in better growth of the baby.
In case there is any problem in the bleeding profile like change in INR or low platelet count then these can be stopped or the dosage can be reduced.
The progesterone vaginal insertion is given to avoid any early pregnancy loss. These are usually not needed after 14 weeks of pregnancy as the hormone is synthesized in the placenta itself.
In case her blood progesterone levels are normal then the supplementation can be gradually stopped.
Regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Rakhi Tayal (4 days later)

Dear Doctor,

My wife's LMP was on 18th nov 2018. we took growth scan yesterday (02/07/2019) that is 32 weeks 2 days. But in scan report the average gestational age shows as 30 weeks 3 days. is this normal?. please advice us.

i have attached yesterday's scan report as well as previous gowth scan report taken on 21st may (26 weeks 2 days). Also i have attached Anomaly scan report taken on 6th April (19 weeks 6 days).

Thanks.

Answered by Dr. Dr. Rakhi Tayal (6 hours later)

Brief Answer:
Baby's growth is on lower side.

Detailed Answer:
Hello.
I have seen all the attached reports. The growth scan done yesterday shows a discrepancy of 2 weeks in he baby's growth. This is suggestive of a growth retardation that can happen due to increased blood pressure of the mother and a decreased placental circulation. The amount of liquor ( AFI 9-10) is also slightly on a lower side. She needs to start with L-arginine supplements and a high protein diet to help with the baby's growth.
Do consult her gynecologist for proper prescription medicines. Her previous scan reports are normal.
Regards.

Above answer was peer-reviewed by : Dr. Prasad